Table 2 Types of support identified by interviewees as in place and valued
Support type | Examples in place |
|---|---|
Leadership from Board | Supporting community consultation process |
Formal meeting with staff to announce final policy decision | |
Individual meetings with concerned staff by Chairperson | |
Formal review of policy at 12 months | |
Leadership from senior clinical team | Support for an open culture |
Appointment of senior clinician as VAD coordinator for first VAD deaths | |
Individual meetings with concerned staff by Manager | |
Support from Medical Advisory Committee | |
Broadening usual support activities that were available for staff and volunteers to include VAD deaths | |
Routine and frequent checking in with involved staff | |
Exploring impact of VAD at exit interviews | |
Policies and procedures | Availability of free confidential counselling (Employee Assistance Program) |
Policy support for varying levels of engagement with VAD | |
Hospice-specific VAD guidelines | |
Support from other members of the MDT | Talking with each other |
Other clinicians coming to family meetings | |
Being asked if OK | |
Support coming “on the job” | |
Discussion at handovers | |
Liaison with other organisations | State-based VAD coordination service |
Forming new community-based hospice networks | |
Learning from the experiences of other organisations | |
New support activities that have developed over time | Post-death MDT debriefs |
Formal monthly group sessions with external psychologist | |
Continually open confidential online feedback form for staff and volunteers |